Reirradiation of head and neck cancer: Long-term disease control and toxicity
SourceHead and Neck-Journal for the Sciences and Specialties of the Head and Neck, 39, 6, (2017), pp. 1122-1130
Article / Letter to editor
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Oral and Maxillofacial Surgery
Head and Neck-Journal for the Sciences and Specialties of the Head and Neck
SubjectRadboudumc 9: Rare cancers RIHS: Radboud Institute for Health Sciences
BACKGROUND: The purpose of this study was to report long-term disease control and late radiation toxicity for patients reirradiated for head and neck cancer. METHODS: We conducted a retrospective analysis of 137 patients reirradiated with a prescribed dose >/=45 Gy between 1986 and 2013 for a recurrent or second primary malignancy. Endpoints were locoregional control, overall survival (OS), and grade >/=4 late complications according to European Organization for Research and Treatment of Cancer (EORTC)/Radiation Therapy Oncology Group (RTOG) criteria. RESULTS: Five-year locoregional control rates were 46% for patients reirradiated postoperatively versus 20% for patients who underwent reirradiation as the primary treatment (p < .05). Sixteen cases of serious (grade >/=4) late toxicity were seen in 11 patients (actuarial 28% at 5 years). In patients reirradiated with intensity-modulated radiotherapy (IMRT), a borderline improved locoregional control was observed (49% vs 36%; p = .07), whereas late complication rates did not differ. CONCLUSION: Reirradiation should be considered for patients with a recurrent or second primary head and neck cancer, especially postoperatively, if indicated. (c) 2017 Wiley Periodicals, Inc. Head Neck 39: 1122-1130, 2017.
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